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Comparative Study
. 2011 Jul-Aug;126(4):508-21.
doi: 10.1177/003335491112600407.

Disparities in infectious disease hospitalizations for American Indian/ Alaska Native people

Robert C Holman  1 , Arianne M Folkema, Rosalyn J Singleton, John T Redd, Krista Y Christensen, Claudia A Steiner, Lawrence B Schonberger, Thomas W Hennessy, James E Cheek
Affiliations
Comparative Study

Disparities in infectious disease hospitalizations for American Indian/ Alaska Native people

Robert C Holman et al. Public Health Rep. 2011 Jul-Aug.

Abstract

Objectives: We described disparities in infectious disease (ID) hospitalizations for American Indian/Alaska Native (AI/AN) people.

Methods: We analyzed hospitalizations with an ID listed as the first discharge diagnosis in 1998-2006 for AI/AN people from the Indian Health Service National Patient Information Reporting System and compared them with records for the general U.S. population from the Nationwide Inpatient Survey.

Results: The ID hospitalization rate for AI/AN people declined during the study period. The 2004-2006 mean annual age-adjusted ID hospitalization rate for AI/AN people (1,708 per 100,000 populiation) was slightly higher than that for the U.S. population (1,610 per 100,000 population). The rate for AI/AN people was highest in the Southwest (2,314 per 100,000 population), Alaska (2,063 per 100,000 population), and Northern Plains West (1,957 per 100,000 population) regions, and among infants (9,315 per 100,000 population). ID hospitalizations accounted for approximately 22% of all AI/AN hospitalizations. Lower-respiratory-tract infections accounted for the largest proportion of ID hospitalizations among AI/AN people (35%) followed by skin and soft tissue infections (19%), and infections of the kidney, urinary tract, and bladder (11%).

Conclusions: Although the ID hospitalization rate for AI/AN people has declined, it remains higher than that for the U.S. general population, and is highest in the Southwest, Northern Plains West, and Alaska regions. Lower-respiratory-tract infections; skin and soft tissue infections; and kidney, urinary tract, and bladder infections contributed most to these health disparities. Future prevention strategies should focus on high-risk regions and age groups, along with illnesses contributing to health disparities.

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Figures

Figure 2.
Figure 2.
Map of the Indian Health Service regionsa in the United States
Figure 3a.
Figure 3a.
Age-adjusted hospitalization rates per 100,000 population among AI/AN people for first-listed and any-listed ID hospitalizations and all-cause hospitalizations (IHS/tribal), 1998–2006
Figure 3b.
Figure 3b.
Regional age-adjusted first-listed ID hospitalization rates per 100,000 population for AI/AN people (IHS/tribal) and overall age-adjusted first-listed ID hospitalization rates for the general U.S. population (Nationwide Inpatient Sample), 1998–2006
See this image and copyright information in PMC

References

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